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One Dependency for Another?

It is not uncommon for those of us working in the addictions arena or those of us in recovery to hear such reports as the following

Methadone just substitutes one drug dependency for another.

He used to be an alcoholic; now he’s a religious fanatic. He just traded one addiction for another.

I saw more of my husband when he was drinking than I do now that he is sober in AA. Sometimes I think he’s addicted to AA.

Is it healthy for her to go to SO many NA meetings? And she practically lives at that 12-Step clubhouse!

He is now quite dependent on his aftercare and Celebrate Recovery meetings—perhaps too dependent.

I find such comments interesting in light of the following observations.

We do not criticize people for prolonged use of medications in the treatment of other chronic disorders (e.g., medications for diabetes, high cholesterol, high blood pressure, asthma, arthritis, etc.), nor do we characterize such use as dependence. Why do we do so with medications used in the treatment of addiction? What would be the consequences if all people with chronic health conditions were pressured to stop taking stabilizing medications?

There is an implicit assumption within statements like the above that dependency of any kind is inherently bad (weakness of character) or emotionally pathological (a psychological disorder). Yet, healthy interdependence is a sign of human health rather than weakness or sickness. Why are we okay with other forms of dependence, but so sensitive to dependence in the addictions arena–even when they constitute a pathway of addiction recovery? Shouldn’t dependence be judged based on its effects on health and social functioning rather than be judged as an inherently inferior style of coping?

High intensity participation in recovery support activities is typical of early stage lifestyle changes. Such intensity usually reaches a state of moderation and balance once the new changes have been fully mastered, stabilized, and integrated into one’s life. And even if such balance is not achieved, it would seem to be best to judge excessive zeal for recovery against the comparative consequences of excessive zeal for intoxication.

So-called “substitute dependencies” reflect the existential and lifestyle void during early stages of recovery. Compulsive adherence to early recovery rituals, black-white thinking, and intolerance of alternative approaches to recovery are not atypical in early recovery and reflect the inability to handle ambiguity and the challenges of complex, nuanced decision-making. Such primitive coping strategies should not be confronted and stripped without alternative means of maintaining psychological equilibrium. The acquisition of such alternatives is a time-dependent process of brain healing and skill acquisition.

Restricting one’s life to closed recovery support activities may be more a reflection of community deficits than personal deficits, e.g., the lack of recovery-supportive space in the larger community. Individuals seeking recovery are likely to close themselves off from the community at large when no recovery-friendly recovery space exists within that larger community. Those criticizing dependency in recovery are often the same people who oppose the expansion of community-based recovery support institutions. Both acts are an expression of addiction-related social stigma.

There is a well-established propensity for other excessive behaviors among those who have experienced drug addictions, but such excess is as likely to be channeled into areas of success and social contribution as into other pathologies. And such post-addiction excess is often a transitory stage in the journey towards balance and harmony.

So, the next time you hear someone criticize dependency in recovery, remind them of the developmental processes of recovery and also the alternative.